Abstract: Indigenous peoples in countries with similar colonial histories have disproportionate burdens of disease compared with non-Indigenous peoples. This research aims to systematically identify and collate studies describing the prevalence of pre-existing diabetes and gestational diabetes, and compare the prevalence of these conditions between Indigenous and non-Indigenous pregnant women in Australia, Canada, New Zealand, and the USA.
Objective: This systematic review and meta-analysis provided a comprehensive assessment of the prevalence of diabetes in pregnancy among Indigenous women in Australia, Canada, New Zealand, and the USA.
Importance of study: These findings have implications for prenatal care services and the monitoring of Indigenous women in industrialised countries.
Study type: Systemic review and meta-analysis.
Methods: This research identified 1348 studies, of which 43 studies with 32 952 441 participants from Australia, Canada, New Zealand, and the USA were included in the systematic review, and 39 of these studies were included in the meta-analysis. 40 of the included studies used a cohort design.
Conclusion: Of all 39 studies on gestational diabetes included in the meta-analysis, 25 (64%) studies, reported crude prevalence odds ratios (PORs) indicating that the odds of having gestational diabetes in pregnancy were higher among Indigenous women than non-Indigenous women. The prevalence of pre-existing diabetes and gestational diabetes was higher in Indigenous pregnant women than in non-Indigenous pregnant women in four countries (Australia, Canada, New Zealand and the USA) with similar histories of colonialism.
- Future research should focus on targeting important risk factors to prevent pre-existing diabetes and gestational diabetes in Indigenous women, and this research should be done in partnership with Indigenous peoples and communities.
- Given the higher prevalence of diabetes in Indigenous women than in non-Indigenous women during pregnancy in Australia, Canada, New Zealand and the USA, policy makers in these countries should consider implementing policies that aim to reduce this disparity between Indigenous and non-Indigenous pregnant women in terms of the prevalence and outcomes of maternal diabetes.
- Health practitioners need to be aware of the increased likelihood of having pre-existing diabetes and gestational diabetes in Indigenous pregnant women, so that they can better support these women before pregnancy, prenatally and postnatally.